Employers face challenge of changing employee health behaviors


Workforce wellness programs can have a noticeable benefit to your bottom line if evaluated correctly, and can improve the quality of life for employees, strengthen the value of their benefits and reduce health-related business costs, a Baltimore-area psychology professor recently reported to the GBC’s Health Care Committee.

Evaluation goes hand-in-hand with success. Employers can directly facilitate health behavior change in their employees, which could jumpstart and sustain their wellness programs and reduce health care costs in the long term, according to UMBC’s Dr. Carlo C. DiClemente, professor and chair of the Department of Psychology at the University of Maryland, Baltimore County and director for the HABITS Lab at UMBC.

DiClemente detailed ways in which employers can understand the stages of the behavioral change process and thus assist employees with making changes to improve their health.

Change is voluntary. Employers cannot force employees to change their behavior, but employers can facilitate the process and offer incentives to encourage change, DiClemente said.

People need to be interested and concerned in making a change and convinced the change is in their best interest before they will commit to a plan of action and then take action to change, said DiClemente. His model breaks this down into five stages: precontemplation, contemplation, preparation, action and maintenance.

Some employers are only concerned with rewarding employees in the action stage, after which employer engagement falls off at the maintenance stage, according to DiClemente. But all stages need to be fully thought-out and reinforced for real, lasting change to occur.

Behavior change is a challenge because it’s hard, multidimensional and requires self-control, but one-trial learning is very rare, said DiClemente. Reinforcing each step of progress along the way is the most common form of learning. Relapse is not a failure; it’s part of the process.

“Relapse isn’t a problem of addiction,” DiClemente said. “Relapse is a problem of behavior change.”

Employers have opportunities at all stages to be part of the health behavior change process. While it may seem like a lot of investment, companies can expect to see savings, he said.

A seven-year longitudinal study on the incremental costs of smoking and obesity on health care costs among adults found that the annual incremental costs of smoking cost companies between $1,274 and $1,401 while the annual incremental costs of morbid obesity (BMI 35+) were between $5,467 and $5,530, DiClemente said.

So how can employers help employees with health behavior change? DiClemente’s suggestions include:
• Take a motivational-enhancing approach
• Pick and be clear about target behaviors
• Target process, not just problem or outcome
• Tailor messages and strategies to values and needs
• Reinforce small successes
• Create a supportive culture and climate

Dr. DiClemente’s full PowerPoint presentation